James Marusek

Many patients after surgery describe hunger as "head hunger" or a false hunger. I had RNY gastric bypass surgery and I did not experience this condition. But here is a link to a thread about this issue with sleeve patients. https://www.bariatricpal.com/topic/191057-false-hunger-from-acid/ Generally various individuals said that head hunger was caused by acid in your stomach. The solution they found was to take a proton-pump inhibitor such as omeprazole (also called over the counter Prilosec) to alleviate the condition. In my case even though I had gastric bypass, my surgeon had me on omeprazole for a year after surgery to allow my stomach to heal properly. At this point since you are only 5 days post-op, I wouldn't worry too much at this point. It could be head hunger or it could be a strong desire to chew.

Your thread is cryptic. What type of surgery are you looking at?

The rate of weight loss varies by individual so trying to compare yourself with others can be deceiving. There are several reasons why the rate of weight loss varies. Once factor is their starting weight. Your tickler on the side if it is current shows a starting weight of 249 pounds and a weight loss of 64 pounds. I suspect the majority of your weight loss was due to being sleeved. So in a sense your results will be atypical. So what was your weight just prior to bypass surgery? Was it less than 200 pounds? A person with a lot of weight to lose can drop a lot of weight quickly after bypass surgery. One who has less weight to lose will generally drop weight at a slower pace. The type of surgery will also have a lot to do with weight loss. Sleeve patients lose weight at a much slower rate than bypass patients. Some do not transition into maintenance mode until 2 years after surgery. Whereas a bypass patient will drop weight quickly and may transition into maintenance relatively quickly. In my case I transitioned around the 7th month post-op. Sleeve patients experience a lot of stalls along their weight loss journey. Bypass patients experience very few. But the further you progress after surgery, the smaller the rate of weight loss becomes. Weight loss just tapers off. Weight loss is achieved during the short weight loss phase through meal volume control. The two operative words here are short and volume. So if you want to maximize your weight loss during this phase, you need to adhere to the program guidelines. The three most important elements after RNY gastric bypass surgery are to meet your daily protein, fluid and vitamin requirements. Food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. Weight loss is achieved after surgery through meal volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. With this minuscule amount of food, it is next to impossible to meet your protein daily requirements by food alone, so therefore you need to rely on supplements such as protein shakes.

We have an ingrained need to chew. The process of chewing release enzymes that help to break down food. The last time you had something to eat, did you give any thought to how long you chewed? Most likely not, as chewing is done, for most people, almost as a habit or unconscious reflex. As soon as a piece of food enters your mouth, you chew and swallow, probably far too quickly. The chewing process, also known as mastication, is actually extremely important, however, and serves as the first step in your digestive process. Saliva contains digestive enzymes, so the longer you chew, the more time these enzymes have to start breaking down your food, making digestion easier on your stomach and small intestine. One of these enzymes is lingual lipase, an enzyme that helps break down fats, for example. Saliva also helps to lubricate your food so it’s easier on your esophagus. Long story short - You have a subconscious need to chew. It may not be the food that you really miss but the act of chewing that is driving you crazy. If that is the problem then it should alleviate once you transition into the solid food stage.

It is common to experiment to find which foods you can tolerate. But keep in mind that the goals in the Maintenance phase is to maintain the weight loss that you have achieved. That can be the most difficult part of this surgery. The following article describes the approach that I am using in the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf Guidelines for avoiding dumping syndrome. Be aware of your individual pre-triggers. Generally your body will tell you just before you reach dumping syndrome. These are called pre-triggers. They can be many things such as hiccups, sneezing, excessive mucous forming quickly, the taste of food changing instantly from good to terrible, and others. Individuals are different and their pre-triggers vary. So when you experience the pre-triggers, stop eating immediately - not one more bite. It is extremely difficult to lay horizontal when you experience dumping syndrome. That means trying to sleep is out. Normally you will suffer for several hours. Generally I will sit and watch TV for several hours. You can find some relieve by forcing yourself to vomit. Emptying your stomach will help bring you rest. As a result I highly recommend that you not eat during the couple hours before bedtime.

It is common for your taste buds to change after surgery. Be willing to experiment. After surgery, my taste buds changed dramatically. Even water changed. In the hospital it tasted excessively chlorinated and I could not drink it. So I experimented. Sugar free popsicles became my best friend. Some individuals find hot or cold can help with fluids. For me, I found that I could tolerate flavored water. So I began using Crystal Light. I also found a new drink Bai which I liked cold. In the winter, I found that I tolerate hot drinks such as piping hot cocoa. But you have to use the "No Sugar Added" variety. Also fine English teas were very good. The fluid requirement is met by a combination. It is not only the water that you drink each day. But also the water you drink when you take your vitamins and medicine. It is the milk you drink. It is the fluids content of the protein shakes. It is the water component of the soups you take. It is met by flavored water such as Crystal Light. It is met by sugar free popsicles. It is met by tea and decaf coffee. It is a combination of all the fluids that you consume during the day.

After surgery, you take a daily blood thinner for awhile. This is to prevent blood clots. But it also make you more susceptible towards bruising.

Many people find it difficult to sleep in bed immediately after surgery and instead sleep in a recliner for a couple day.

Congratulations.

Congratulations.

Congratulations.

Thanks for the fine details. It provides newbies with what its like the first week after surgery.

Congratulations.

Good luck and remember after surgery to Walk, Walk, Walk. It will help to alleviate the gas pain.

Yes. After surgery, the water in the hospital tasted excessively chlorinated - like swimming pool water. I could drink it. I liked the crushed ice but I like the sugar free popsicles even better.

I think the approach that different people find to be successful will vary by individual. It is not a one size fits all approach. Many are successful after sleeve surgery by tracking everything. They are fanatical about this. Luckily they have modern technology to help them. Such as calorie counter apps.

Your vitamin requirement depends on the type of surgery you had. What type of surgery did you undergo and what vitamins are you currently taking?

Right after surgery, many people find it difficult to meet their daily protein and fluid requirements. That is because your body is in a major heal mode. Just keep working toward your daily goals and you should be able to get there. Things will improve each day after surgery, but it does not happen overnight. It took me 6 months to reach my happy state, when all the problems seemed to melt away.

Good luck on your recovery.

Probably 6 months to a year. When I eat out now, I eat a small portion of the food and box the rest. It gives me 2 or 3 additional meals days afterward. You will spend more time in conversation after surgery during the meals. When your stomach heals enough, you can transition to protein bars. This will help you meet your daily protein goals when you are on the go.

Great detail and good luck with your recovery.

The three most important elements after surgery are to meet your daily protein, fluid and vitamin requirements. Food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. Weight loss is achieved after surgery through meal volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over time increase the volume of your meals. With this minuscule amount of food, it is next to impossible to meet your protein daily requirements by food alone, so therefore you need to rely on supplements such as protein shakes for awhile. Protein Requirement 75-90 grams of protein per day Your daily protein requirement is met by a combination of the amount of protein you obtain from food combined with the amount of protein from protein supplements (protein shakes, protein bars). There are many different types of formulations on protein shakes. I would recommend that you keep experimenting until you find one that you can tolerate. You don't have to like it, just tolerate it. I used Muscle Milk Light (Vanilla Creme) powder blended with water and a half a banana. That worked for me. But on the opposite end of the spectrum, you might try premixed Isopure. Without sufficient protein, your body will scavenge protein from other areas of your body, such as your muscles. Protein is extremely important after surgery as its job in the body is to build and maintain tissues including your body's major organs and skeletal muscles. Protein deficiency, when continued over a long period of time can cause a disease known as protein caloric malnutrition. Common symptoms are poor healing, fatigue, hair loss and muscle wasting. Immediate post op, protein promotes healing of the staple line and incisions. Fluid Requirement 64-80 ounces of fluids per day It is common for your taste buds to change after surgery. Be willing to experiment. After surgery, my taste buds changed dramatically. Even water changed. In the hospital it tasted excessively chlorinated and I could not drink it. So I experimented. Sugar free popsicles became my best friend. Some individuals find hot or cold can help with fluids. For me, I found that I could tolerate flavored water. So I began using Crystal Light. I also found a new drink Bai which I liked cold. In the winter, I found that I tolerate hot drinks such as piping hot cocoa. But you have to use the "No Sugar Added" variety. Also fine English teas were very good. The fluid requirement is met by a combination. It is not only the water that you drink each day. But also the water you drink when you take your vitamins and medicine. It is the milk you drink. It is the fluids content of the protein shakes. It is the water component of the soups you take. It is met by flavored water such as Crystal Light. It is met by sugar free popsicles. It is met by tea and decaf coffee. It is a combination of all the fluids that you consume during the day. Vitamin Requirement Three Flintstone's complete chewable multivitamins daily (or equivalent) 1200 to 1500 mg. Calcium Citrate daily 500 to 1000 micrograms sublingual B12 weekly or 1000 mcg. IM injection once monthly. 100 mg. Thiamine (Vitamin B1) weekly. It is important to put a 2 hour separation between the vitamins that contain iron and those that contain calcium. I was told not to use gummy vitamins because they are not absorbed properly nor to use any time release vitamins.

I found that having weight loss surgery was one of the best decisions I ever made. So good luck. Since you are at the beginning of this process, I would recommend three things. 1. Take a good before photograph of yourself, so that you have something to compare to after surgery. Many times we are blind to our obesity. We do not see ourselves. Therefore when the weight begins to drop off rather dramatically, we question if this is really happening. Photographs are a good visualization of our success. Many people carry a before and after photo with them, just to remind themselves of their success. 2. Walk 30 minutes each day, every day until surgery (or equivalent exercise). Walking helps the recovery process go smoothly and minimized the pain levels from surgery. 3. Wean yourself from caffeine and carbonated beverages now. After I gave up my 6 diet coke a day habit, I suffered from a week of severe withdrawal syndrome consisting of severe headaches and body aches. I was miserable. You don't want to combine the effects of caffeine withdrawal with the effects of surgery.

Sounds good. Focus on the important stuff. Develop a thick skin and let everything that is not important to simply roll off.

No, not always. Understand that you are about to undergo a major operation and the fear can cause additional stress and restlessness. Also you were probably given a requirement to offload caffeine. When I gave up my caffeine habit (6 diet cokes a day), I suffered through a week of caffeine withdrawal syndrome which consisted of severe body aches and headaches. This might also be a potential cause.